视网膜静脉阻塞的临床治疗及疗效分析  

Analysis of therapeutic effects of different clinical approaches for retinal vein occlusion

作　　者：杨继红[1] 张海宁[1] 吴子旭[1] 孟美林[1] 

机构地区：[1]山西省眼科医院,太原市030002

出　　处：《中国实用眼科杂志》2008年第12期1316-1320,共5页Chinese Journal of Practical Ophthalmology

基　　金：山西省卫生厅科技攻关计划项目（200731）

摘　　要：目的应用光学相干断层扫描长期随访视网膜静脉阻塞患者，观察视网膜黄斑水肿的变化情况，确定最佳的治疗方法和治疗时机。方法将视网膜静脉阻塞患者75例，分成光凝治疗组，曲安奈德治疗组，联合治疗组；对比分析治疗前与治疗后1、3、6、12个月、2年视网膜神经上皮层厚度及视力的变化。将联合治疗组分成光凝术后1个月内和1个月后玻璃体腔内注射曲安奈德两小组。结果（1）三组患者治疗后黄斑水肿明显减轻，治疗前与治疗后不同时期黄斑水肿高度比较差异有统计学意义（P〈0．05）。三组患者治疗后与治疗前相比，随访末次视力提高者分别为14、14和16例。将联合治疗组的两小组黄斑水肿高度进行比较，差异有统计学意义（P〈0．05）。光凝术后1个月内球内注射曲安奈德的患者长期疗效较好。（2）将三组患者随访末次黄斑水肿高度进行比较，差异有统计学意义（P〈0．05）。结论长期疗效，联合治疗的疗效及视力的提高比较显著，且激光光凝治疗后1个月内球内注射曲安奈德对黄斑水肿的长期疗效更加显著。Objective The aim of the study was to compare the therapeutic effects of three clinical approaches for the patients suffering from retinal vein occlusion by observing the changes in the macular edema using OCT.Methods Seventy-five patients suffering from retinal vein occlusion were divided into three groups： laser coagulation, intravitreal triamcinilone acetonide or the combination of the two methods.The examinations of OCT and visual acuity were carried out before the treatment and 1,3,6,12 and 24 months after the treatment.The group of patients treated with the combination of the methods was further divided in to two sub-groups according to the time of the intervals between the treatmentsece.Results We compared the retinal thickness of the three groups at last time follow-up periods.The difference was statistically significance（P 〈0.05 ）,The visual acuity were improved.Conclusion The three methods were effective for the patients suffering from retinal vein occlusion.The combination of the two methods compared with two other methods was more effective.The combination of the two methods,i.e.,intravitreal injection with triamcinolone acetonide within 1 month after the treatment of laser coagulation,were obviously effective.

关 键 词：视网膜静脉阻塞 激光光凝术 曲安奈德 光学相干断层扫描 

分 类 号：R774.1[医药卫生—眼科] R563.1[医药卫生—临床医学]